Rewards for watching TV vs rewards for healthy behavior

By: Neil Versel | Feb 7, 2013        

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Neil_Versel_LargeHealth gamification app developers, you may have met your match. You probably already knew the couch potato was your biggest challenge. But now the stakes have been raised.

The other night, I was watching TV and this commercial came on: (Watch here).

That’s right, there’s an app, called Viggle, that rewards people for sitting on their rear ends and “checking in” to their favorite shows. Users get bonus points for watching certain programs — including hugely popular ones like “Modern Family” and “Law and Order: Special Victims Unit,” as well as live sporting events. They then can redeem points for prizes, for example, a Papa John’s gift card, because nothing reinforces the sedentary lifestyle like free pizza.

And despite what that specific commercial said, Viggle is not just for DirecTV subscribers.

Trying to convince people to download and use mobile apps and gadgets to get active already has been a tough sell. Which is why I was underwhelmed by this week’s news that smartphone accessory maker Jawbone, producer of the failed – but later revived – UP sleep and activity tracker had acquired Massive Health, maker of, well, I’m still not exactly sure.

Massive Health did come out with an “experiment” in 2011 called The Eatery that to me seems like the “Hot or Not” of food photos. There was another iPhone app for diabetes management supposedly called Penguine, but that never got a public release.

Business development chief Andrew Rosenthal once told MobiHealthNews that Massive Health’s differentiator was its user-centeredness. “Our approach has always been to focus on user engagement partly because no one else does. The more someone loves something, the more they use it, and the more opportunities we will have as a company to help them be healthy,” he said.

Pardon my skepticism, but hasn’t everyone peddling a DTC health tool focused on user engagement? Isn’t that the point of all the gamification apps, widgets and gizmos?

I never was able to find anything unique about Massive Health, other than its Massive Hype. It had a high-minded business name, a Silicon Valley rock star on board — namely former Mozilla Firefox creative lead Asa Raskin — and a lot of buzz. But no real breakthroughs or much in the way of actual products.

Come to think of it, that’s not so unique, either. Revolution Health had a similar grandiose name and an even bigger IT rock star, Steve Case, behind it. Google Health had early XML developer and former Microsoft project leader Adam Bosworth, not to mention the Google name and reams of undeserved press. Both of those failed pretty miserably. Bosworth’s subsequent venture, Keas, just announced yet another change of direction this week.

What those projects all have in common is that they never figured out some of the basic realities of healthcare. Fitness and healthcare are distinct markets. The vast majority of healthcare spending comes not from workout freaks and the worried well, but from chronic diseases and acute care. Sure, you can prevent a lot of future ailments by promoting active lifestyles today, but you might not see a return on investment for decades.

Another problem is that Massive Health, Google Health, Revolution Health and Keas never came to grips with the fact that healthcare is unlike any other industry.

In the case of Google and every other “untethered” personal health record out there, it didn’t fit physician workflow. That’s why I was disheartened to learn this week that one of the first two development partners for Walgreens’ new API for prescription refills is a PHR startup called Healthspek. I hate to say it, but that is bound to fail unless Walgreens finds a way to populate Healthspek records with pharmacy and Take Care Health System clinic data.

Plus, doctors don’t trust patient-entered data and patients, for the most part, won’t bother to enter their own information in the first place. It’s like Quicken in the days before online banking let people download all their transactions. You need the interoperability first.

The other thing working against the likes of some of these companies is the economics of healthcare. Third parties pick up most of the tab. People freak out when their health plans raise co-pays or employers ask them to cover more of their monthly premiums. Direct-to-consumer just doesn’t work. You have to go to those who pay the bills, namely insurers and employers. Keas did that in a previous refocusing, but I haven’t seen any evidence that Massive Health ever did.

As Verizon Wireless healthcare director John Maschenic wondered out loud in 2010, “I pay $18 a month for OnStar to manage the health of my car, but people aren’t willing to pay more than [$5 a month] to manage their own health information?” Yes, it’s true. And it doesn’t seem to be changing very fast.


Mayo pilot adds Fitbit data to heart patient app

By: Jonah Comstock | Feb 7, 2013        

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mayo clinic mycare

In November 2012, Mayo Clinic completed its pilot of an in-hospital, patient-facing iPad app for helping patients and their families through cardiac surgery, according to a report from consumer health engagement consultant Sherri Dorfman. The pilot of 149 cardiac surgery patients aged 52 to 85, which began in February 2012, made headlines in April last year when Mayo Clinic posted a video about it on YouTube.

The app, called MyCare, is a patient communication app that shows patients and their families a personalized “Plan of Stay,” laying out on a calendar when each part of the prep, surgery, and recovery is due to happen. The app also embeds educational modules through each step of the process. During the surgery, the app is designed to help families follow along and understand what’s happening to the patient. Prior to the pilot, the Mayo Clinic conducted focus groups with surgery patients and their families to determine how best to design the app and the program.

The app also lets the patient report their progress during recovery, telling the doctors how much they’ve walked or eaten each day, for instance. The Mayo Clinic’s Dr. David J. Cook told Dorfman that the app helped to reduce hospital stays for some patients, because the app alerted doctors when patients weren’t meeting recovery expectations, which allowed them to mobilize sooner.

Mayo sent surveys out to track patient and family satisfaction with the surgery experience, and over 90 percent were satisfied with the experience, although without a control group to compare it’s hard to say how much the app contributed. More than 80 percent of patients said they felt very comfortable using the app, despite the age of the population.

Because of security concerns, the app was only used within hospital walls during the pilot. However, Cook told Dorfman that once those concerns are addressed, they hope to design the app to support patients throughout the home phase of their recovery as well. He also said that the app currently supports Fitbit integration to track patients’ movement, and the plan is to integrate with a range of remote monitoring devices.

Mayo also developed a patient app for the iPad in May 2012 which included prescription refills, secure messaging, and a portal for accessing patient information.

Frog: Healthcare to shift from Rx to choice

By: Jonah Comstock | Feb 7, 2013        

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fabio sergioFrog Design Executive Creative Director Fabio Sergio has published a must-read essay on healthcare innovation over at Frog Design’s site, arguing not only that developments like Big Data and wearable devices will improve healthcare, but also that they will — and should — fundamentally change the healthcare system and the meaning of roles like patient, caregiver, and healthcare professional.

Sergio, who has worked with Frog clients Novartis, Johnson & Johnson, and UNICEF, says new players are having an increasing influence over the future of healthcare. Designers who control how healthcare is accessed, Sergio says, are “strategically helping to make the larger-scale experience of healthcare more engaging and effective.” Telecom companies, as well, have the opportunity to become players in the healthcare space.

“Healthcare was once a domain of hardcore healthcare-focused players,” Sergio writes. “Today, there are numerous non-traditional health service providers — Nike, Fitbit, Microsoft, Qualcomm — moving quickly into this space. And with health-related services like Asthmapolis or [Massive Health’s] The Eatery sitting on an iPhone or Android screen beside Twitter, YouTube, or Facebook applications, the boundaries between lifestyle and life-care are blurring, perhaps even fading away.”

Sergio makes the case that this blurring of lifestyle and care is dovetailing with an institutional emphasis on prevention rather than treatment.

“In most cases and countries the quality of a healthcare system is only measured when treating a disease, and only then the economic incentives of reimbursement come into play to propel the system forward. The key to make healthcare sustainable in the future will be to understand what incentives will be needed to tip the entire system towards prevention,” he writes.

Rather than characterizing the shift in healthcare as from patient to consumer, Sergio argues it should be conceptualized as a shift “from prescription to choice.” Patient communities and online diagnosis tools empower people by giving them information, so everyone can interact with the healthcare system not as a patient or as a consumer, but simply as a person.

“In the next chapter of the industry formerly known as healthcare, people will start to see the care of their health as a lifelong narrative,” he writes. “Science is now telling us how our life stories might begin as early as in the womb, when we are affected by what our mothers eat when they are pregnant, and effective storytelling is likely to become a key ingredient in any effective healthcare solution. These stories will be about people’s lives, not about the diseases that happen to affect them. Although there will be more data available about people’s health experiences, they will learn and demand to be understood and spoken with as human beings and individuals, and not be considered a statistic.”

Sergio reiterates the often-made point that Big Data is not as important as the interpretation of that data, and suggests (without naming names) that some services that attempt to create behavior change by tracking health data and providing it to the users are doomed to fail if they don’t find a way to make that data meaningful and relevant.

Addressing the question of the necessity of the yearly physical, Sergio predicts the doctor’s visit itself isn’t going away, but it will be conducted differently: possibly remotely, via video messaging, but probably with a shared information display, with “conversations facilitated and sustained by information shown on displays that can be interacted with by both parties.” The presence of home monitoring devices, from fitness trackers and connected weight scales to home blood pressure monitors and iPhone EKGs, will introduce more data into the conversation, and that data will be openly shared between both parties.

Sergio also acknowledges how difficult change is for a system as entrenched and risk-averse as healthcare. Nonetheless, he suggests that the shifts he’s describing have already begun, and it’s the responsibility of everyone in digital health to keep pushing on the status quo, to bring about a new future for healthcare.

Sotera Wireless lands $14.8M in new financing

By: Neil Versel | Feb 7, 2013        

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visi-productsSotera Wireless, maker of the wrist-worn ViSi Mobile wireless vitals monitoring system, has landed $14.8 million in fresh capital, including $1.33 million from Safeguard Scientifics and an undisclosed amount from another new investor, Delphi Ventures.

Other participants in this round include previous shareholders Sanderling Ventures, Qualcomm Ventures, EDBI, Intel Capital, Cerner Capital and the West Health Investment Fund, according to Wayne, Pa.-based Safeguard. With its investment, Safeguard gains a seat on Sotera’s board of directors and now holds a 7.7 percent stake in Sotera. Safeguard also has an agreement to increase its share to 20 percent under certain, unspecified scenarios.

“We believe that Sotera’s ViSi Mobile addresses a large market, with the opportunity to revolutionize the way hospitals monitor patient vital signs. ViSi Mobile fills an unmet medical need, has the potential to reduce healthcare spending, and can rapidly improve patient management while achieving significant growth,” Safeguard Executive VP and Managing Director James A. Datin, who is the newest Sotera board member, says in a press release.

“Through this financing, we can provide Sotera with the necessary resources to help increase ViSi Mobile’s penetration into hospitals throughout the United States, and encourage the development of other, complementary products that build upon Sotera’s proprietary technology,” Datin adds.

San Diego-based Sotera will use the cash infusion to augment its sales network and add channel distributors, the company says. “With $14.8 million in additional capital, we believe that we can accelerate our commercialization and clinical development, and expand the availability of ViSi Mobile to the more than 5,000 hospitals in the United States,” Sotera CEO Tom Watlington explains.

ViSi Mobile got a major publicity boost a couple of weeks ago when Dr. Eric Topol, who helped develop the wrist monitor at Scripps Health in San Diego, showed off the device in his appearance on “Rock Center with Brian Williams” that aired Jan. 24 on NBC.

The product gained full FDA 510(k) clearance last August.

Aetna’s fitness app Passage uses Instagram, Google Maps

By: Jonah Comstock | Feb 6, 2013        

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passageAt the mHealth Summit in December, when Aetna CEO Mark Bertolini announced a March 2013 launch of the mobile version of Aetna’s CarePass platform, he also previewed a fitness app called Passage: A Virtual Journey. The free app is available to everyone, not just Aetna members.

“Instead of staring at a book while you’re on your elliptical or stairclimber, what we have is an opportunity to turn your fitness into a journey, wherever you want to go,” he said at the time. “It engages the consumer in thinking about places they want to go, sets goals, and allows them to make the journey personal and complete, bringing the world to them.”

Earlier this week, the app launched for iPhone, iPod touch, and iPad on the iOS AppStore. The app uses the Apple device’s built-in accelerometers as a pedometer to track the users’ steps whenever the app is open and running. It translates those steps to a virtual display of another location, shown on the screen in a 360 degree view. The app starts out with a course through Paris, which the user must complete in order to unlock subsequent locations.

As the user virtually moves through the city, the app displays Instagram photos from their virtual location, tourist facts, and “hidden gem” restaurants, as well as allowing users to see their virtual location on a Google map and displaying the local time and weather.

The app requires the user to sign on to Aetna’s CarePass portal, a fitness hub initiative that has been a big part of Aetna’s strategy recently. CarePass will allow a range of health and fitness apps, including big ticket acquisition iTriage, to send information freely to one another on a user’s phone, keeping them all securely behind a CarePass login. The system has an open API, which the company hopes will entice third-party apps to connect to CarePass.

Many apps use gamification to turn exercising into something more — the popular “Zombies, Run!” app uses virtual zombies to motivate runners, and MeYou Health’s “Monumental” takes an approach similar to Passage, translating a user’s stairclimbing into climbs of mountains and monuments around the world. UnitedHealth, another payer, has made “OptumizeMe,” an app that uses social features and challenges to promote movement, available for several years.

While not a radically different concept, Aetna’s new Passage app is just one more gamified piece in the company’s effort to make a CarePass a one-stop shop mobile health interface, for anyone to download.

Sanofi helps launch Prost8Care, SMS-based program for prostate cancer treatment

By: Neil Versel | Feb 6, 2013        

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Prost8CareIt’s been employed for weight loss, flu vaccination, glaucoma treatment, diabetes management, prenatal care and several other health conditions and services. Now, text messaging is getting a tryout for men with advanced prostate cancer.

Mobile software developer Mobile Commons, pharmaceutical company Sanofi US and the Prostate Cancer Foundation on Tuesday announced the creation of Prost8Care, an SMS system to help prostate cancer patients and their families understand treatment processes.

“Through Prost8Care, we are helping those coping with advanced stages of the disease through text messages timed to coincide with their chemotherapy treatment cycles,” Prostate Cancer Foundation Chief Scientific Officer Howard Soule says in a press release.

Patients will enroll via their doctors. The program will send printed informational and enrollment material to physician offices. Once patients are signed up, they should start receiving text messages, with tips on eating properly and coping with chemotherapy side effects, timed to each man’s treatment cycle, the companies say.

“The goal of Prost8Care is to encourage patients and educate them, and facilitate productive conversations with their physicians throughout the course of their treatment. And because 95 percent of Americans with chronic diseases have access to texting, this may be an effective way to reach these patients,” Mobile Commons CEO Jed Alpert says.

Prost8Care is a one-way messaging program, so participants will not be asked to respond to the texts. There is no cost other than carrier messaging charges.